According to the Institute of Medicine (IOM), the quality of healthcare refers to the level to which services provided meet the desired outcomes as well as their score of consistency when measured against contemporary professional knowledge (National Academy of Sciences, 2018). Quality care is effective, efficient, safe and timely, centered on the patient’s problems, and promotes equity (AHRQ.gov, 2018). Quality measurement and improvement involve a robust process of research using statistical methods and specific measurement tools.
Quality Indicators
Quality measurement and improvement research involve an evaluation of the quality indicators in the four areas: prevention, inpatient, patient safety, and pediatric quality (AHRQ.gov, 2018). Prevention quality indicators are useful to help assess the extent of access to care at the community level. It involves an assessment of both access to primary care or outpatient care in the community. Inpatient safety indicators are useful to assess the quality of care provided to adults in hospitals. Patient safety indicators serve to assess the safety of patients at the hospitals as well as record improvements through monitoring. Pediatric quality indicators are used in an assessment of the quality of care delivered to children, both in the community setting and at the hospital.
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Quality Measurement and Improvement steps
The steps in quality improvement and measurement start with the identification of the quality indicators and defining performance aspects that need improvements. Second, it involves identifying the baseline performance assessment for every measure. The third step is to set the performance goals for every measure. The team then outlines the actions to achieve the performance goals, for every measure. Fifth, it will involve remeasuring the performance-based in the different actions. Finally, it involves an assessment to outline the improvement.
Statistical Methods and Specific Tools
There are specific tools used in quality measurements and improvement tools (ASQ, 2018). The cause-and-effect diagram is applicable to collect data on the causes of a problem and their resultant effects. It is important to categorize identified quality concerns, identify their causes and enumerate the potential and real consequences. The cause-and-effect diagram can be used to assess the causes of long patient waiting time in the general outpatient department of a community hospital.
A check sheet is useful in data collection and analysis for diverse quality concerns or issues. Third, a control chart is applicable as a monitoring tool to view and record changes in a process over a defined period. For instance, checklists can be useful to determine patients’ readiness for extubation in a pediatric care hospital.
Histograms are used to display frequencies of values in a set of data. Histograms are useful to see if there have been changes to a process, such as patient discharge time in a community hospital.
A Pareto chart is useful to display information in when analyzing frequencies of either problems or causes in a process. A Pareto chart can be applicable to plot the number of patients’ complaints concerning an identified service at a community hospital.
A scatter diagram is important to pair data in numerical form and to deduce the resultant relationship between variables under analysis. A scatter diagram can be applied to determine the effectiveness of a training program and based on the number of inquiries on the helpline recorded after training staff on the use of a program compared to prior to the training.
References
AHRQ.gov (2018). Quality Improvement and monitoring at your fingertips . Retrieved from https://www.qualityindicators.ahrq.gov/
AHRQ.gov (2018). Understanding Quality Measurement . Retrieved fromhttps://www.ahrq.gov/professionals/quality-patient-safety/quality-resources/tools/chtoolbx/understand/index.html
ASQ. (2018). QUALITY TOOLS A TO Z. Retrieved from https://asq.org/quality-resources/quality-tools
National Academy of Sciences (2018). Crossing the Quality Chasm: The IOM Health Care Quality Initiative. Retrieved from http://www.nationalacademies.org/hmd/Global/News%20Announcements/Crossing-the-Quality-Chasm-The-IOM-Health-Care-Quality-Initiative.aspx
